Validation of the Asthma Severity Scoring System (ASSESS) in the ALLIANCE Cohort
Authors: Ruth Grychtol, Lennart Riemann, Svenja Gaedcke, Bin Liu, David DeLuca, Reinhold Förster, Nicole Maison, Dominik Thiele, Nikolas Jakobs, Thomas Bahmer, Meike Meyer, Svenja Foth, Stefanie Weber, Ernst Rietschel, Klaus F. Rabe, Matthias V. Kopp, Erika von Mutius, Anna-Maria Dittrich, Gesine Hansen, Oliver Fuchs, Barbara Roesler, Nils Welchering, Naschla Kohistani-Greif, Johanna Kurz, Katja Landgraf-Rauf, Kristina Laubhahn, Nicole Maison, Claudia Liebl, Bianca Schaub, Markus Ege, Erika von Mutius, Sabina Illi, Alexander Hose, Esther Zeitlmann, Mira Berbig, Carola Marzi, Christina Schauberger, Ulrich Zissler, Carsten Schmidt-Weber, Isabell Ricklefs, Gesa Diekmann, Lena Liboschik, Gesche Voigt, Laila Sultansei, Markus Weckmann, Matthias V. Kopp, Gyde Nissen, Inke R. König, Dominik Thiele, Thomas Bahmer, Anne-Marie Kirsten, Frauke Pedersen, Henrik Watz, Benjamin Waschki, Klaus F. Rabe, Christian Herzmann, Mustafa Abdo, Heike Biller, Karoline I. Gaede, Xenia Bovermann, Alena Steinmetz, Berrit Liselotte Husstedt, Catharina Nitsche, Vera Veith, Marlen Szewczyk, Folke Brinkmann, Anna-Maria Dittrich, Christine Happle, Ruth Grychtol, Aydin Malik, Nicolaus Schwerk, Christian Dopfer, Mareike Price, Gesine Hansen, Adan Chari Jirmo, Anika Habener, None Dipl-Biol, David S. DeLuca, Svenja Gaedcke, Bin Liu, Mifflin-Rae Calveron, Stefanie Weber, Svenja Foth, Chrysanthi Skevaki, Harald Renz, Meike Meyer, Tom Schildberg, Ernst Rietschel, Silke van Koningsbruggen-Rietschel, Miguel Alcazar
Journal: Journal of Allergy and Clinical Immunology (2023)

The Asthma Severity Scoring System (ASSESS) quantifies asthma severity in adolescents and adults. Scale performance in children younger than 12 years is unknown.To validate the ASSESS score in the All Age Asthma Cohort and explore its use in children younger than 12 years.Scale properties, responsiveness, and known-group validity were assessed in 247 children (median age, 11 years; interquartile range, 8-13 years) and 206 adults (median age, 52 years; interquartile range, 43-63 years).Overall, measures of internal test consistency and test-retest reliability were similar to the original data of the Severe Asthma Research Program. Cronbach α was 0.59 in children aged 12 to 18 years and 0.73 in adults, reflecting the inclusion of multiple and not-always congruent dimensions to the ASSESS score, especially in children. Analysis of known-group validity confirmed the discriminatory power, because the ASSESS score was significantly worse in patients with poor asthma control, exacerbations, and increased salbutamol use. In children aged 6 to 11 years, test-retest reliability was inferior compared with that in adults and adolescents (Cronbach α, 0.27) mostly because of a less lung function impairment in children with asthma of this age group. Known-group validity, however, confirmed good discriminative power regarding severity-associated variables similar to adolescents and adults.Test-retest reliability and validity of the ASSESS score was confirmed in the All Age Asthma Cohort. In children aged 6 to 11 years, internal consistency was inferior compared with that in older patients with asthma; however, test validity was good and thus encourages age-spanning usage of the ASSESS score in all patients 6 years or older.